Background/Objectives: Chronic rhinosinusitis with nasal polyps (CRSwNP) is a type 2 inflammatory disease often resistant to standard treatments. Dupilumab, a monoclonal antibody targeting the IL-4α receptor, has shown efficacy in CRSwNP, but a significant subset of patients do not respond to this therapy. This study aims to investigate pretreatment complete blood count (CBC)-based inflammatory biomarkers as predictors of response to dupilumab in patients with CRSwNP. Methods: This mono-centric, retrospective, single-arm longitudinal cohort study included 80 patients with uncontrolled CRSwNP who received dupilumab treatment at the Medical University of Graz. Patients were classified into responder and non-responder groups based on a reduction of >1 in nasal polyp score (NPS) and a sinonasal outcome test-22 (SNOT-22) score <40 points at six months. Pretreatment CBC-derived biomarkers, including eosinophil count, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and systemic inflammation indices including the aggregate inflammation systemic index (AISI), systemic inflammation index (SII), and systemic inflammation response index (SIRI), were analyzed for their predictive value. Results: Of the 80 patients, 72.5% were classified as responders, while 27.5% were non-responders. A significant positive correlation was found between baseline eosinophil count and NPS reduction (p = 0.027), suggesting that higher eosinophil levels may predict higher NPS reduction in dupilumab treatment. However, no significant associations were observed between NLR, PLR, and systemic inflammation indices with treatment outcomes. Conclusions: Pretreatment eosinophil count may serve as a potential biomarker for predicting nasal polyp reduction in dupilumab treatment of CRSwNP. Other CBC-based inflammatory markers did not show significant predictive value. Further prospective studies are needed to validate these findings and explore additional, reliable biomarkers to optimize treatment outcomes for CRSwNP patients.

Introduction: Intratympanic steroid (ITS) injections represent an increasingly used salvage treatment option for patients with idiopathic sudden sensorineural hearing loss ­(ISSHL) after systemic treatment. The most effective corticosteroid for this treatment modality still remains unclear. Triamcinolone acetonide has been used for ITS treatment in various clinical settings. However, there are limited clinical data of its usage in the therapeutic management of ISSHL. The aim of this study was to determine the efficacy of intratympanic triamcinolone acetonide injections as a salvage treatment for ISSHL. Methods: We conducted a retrospective chart review on patients affected by ISSHL with insufficient hearing recovery after primary systemic corticosteroid therapy and who were treated with intratympanic triamcinolone acetonide as a salvage therapy between January 2014 and August 2019. The patients were divided into groups according to their degree of hearing recovery, and we evaluated potential predictors of hearing recovery. Audiometric results were then compared to historic studies using dexamethasone or methylprednisolone. Results: One-hundred and fifty-two patients received up to 3 intratympanic injections with triamcinolone acetonide at 1-week intervals. The mean hearing improvement due to ITS salvage treatment was 15.9 ± 18.9 dB. Complete hearing recovery was noted in 15 patients (9.9%), while 73 patients (48%) obtained partial recovery, and 64 patients (42.1%) had no recovery. Primary systemic treatment delay, hearing improvement by primary systemic treatment, and severity of initial hearing loss were identified as significant predictors of hearing improvement. The first of the 3 injections resulted in the greatest hearing improvement. Conclusion: The use of triamcinolone acetonide in ITS salvage treatment resulted in similar hearing improvements as the use of the commonly used corticosteroids, namely, dexamethasone and methylprednisolone. Longer treatment delays, lower hearing improvement by primary systemic treatment, and higher initial hearing loss are associated with poorer prognoses of hearing recovery.

Chronic rhinosinusitis with nasal polyps (CRSwNP) significantly impacts quality of life and often presents therapeutic challenges, with biologics like dupilumab showing promise in managing severe, uncontrolled cases. The aim of this study was to assess the influence of overweight on the effectiveness of dupilumab in patients with uncontrolled CRSwNP. This retrospective study analyzed treatment outcomes of 75 CRSwNP patients receiving dupilumab, categorizing them into underweight/normal-weight (BMI ≤ 24.9 kg/m²) and overweight/obese (BMI ≥ 25 kg/m²) groups. Outcome measures included changes in nasal polyp score (NPS) and sinonasal outcome test (SNOT-22) scores. Results demonstrated that the underweight/normal-weight group experienced significantly greater improvements in NPS and a higher rate of total NPS improvement compared to the overweight/obese group. While SNOT-22 scores improved in both groups, no significant differences were observed. Among patients with comorbid asthma, the underweight/normal-weight subgroup also showed significantly better outcomes, including greater reductions in both NPS and SNOT-22 scores. Multiple regression analysis identified BMI as an independent prognostic factor for NPS outcomes. The findings suggest that overweight/obesity adversely affects the response to dupilumab in CRSwNP, emphasizing the need for personalized treatment strategies considering BMI.

Objectives: to evaluate our real-world data on the efficacy and safety of switching between two monoclonal antibodies in biologic treatment of uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP). Methods: All patients receiving biologic treatment for uncontrolled CRSwNP between April 2020 and March 2024 at a tertiary referral center who needed transitioning between biologic agents were retrospectively analyzed. The following parameters were investigated: patient’s clinical characteristics, wash-out periods, treatment outcome, and switching-related side effects. Results: Out of 91 CRSwNP patients who received biologic treatment, 4 patients (4.4%) necessitated switching to an alternative biologic agent. Three patients were switched to a different antibody because of insufficient symptom control with the initially prescribed biologic, while the other patient required switching to an alternative agent due to a side effect. Switching resulted in all four patients achieving a significant improvement in all outcome parameters. There were no switching-related side effects, and the switching procedure was performed in three cases without a wash-out period. Conclusion: CRSwNP patients under biologic therapy with an insufficient response or medication-related side effect may benefit from switching to an alternative biologic agent. Larger, prospective multicenter studies are warranted to further validate the effectiveness and safety of switching agents in the biologic treatment of CRSwNP.

Background/Objectives: During the COVID-19 pandemic, Austria, like many European countries, implemented lockdown measures to curb viral transmission. These public health interventions, including social distancing and improved hygiene, were anticipated to affect various infectious diseases. This study aimed to assess whether the incidence of peritonsillar abscess, a severe upper respiratory inflammatory disease, decreased during the lockdown period of 2020 compared to previous years. Methods: This retrospective study analyzed all patients diagnosed with peritonsillar abscess from 2010 to 2020 at the Department of Otorhinolaryngology, Medical University of Graz. Patients were grouped based on the onset of disease into two periods: the lockdown period (16 March–29 May) and the rest of the year = Period 2 (1 January–15 March and 30 May–31 December). The incidence during the lockdown period of 2020 was compared to the incidence in the same timeframe in the previous years from 2010 to 2019 using chi-squared tests and Poisson regression models. Results: A total of 1768 patients (female: 44%, male: 56%; mean age: 34.6 ± 18.4 years) diagnosed with peritonsillar abscess were treated between 2010 and 2020 at the Department of Otolaryngology, Medical University of Graz. The analysis revealed that the proportion of peritonsillar abscesses in Period 1 in 2020 (15/127, 12%) was significantly lower than the mean proportion in Period 1 from 2010 to 2019 (36/164, 22%) (p = 0.004). The incidence rate of peritonsillar abscess cases per year in Period 1 (16 March–29 May) was significantly higher in each previous year from 2010 to 2019 compared to 2020 (p < 0.05). Conclusions: The findings suggest that the COVID-19 lockdown measures contributed to a reduction in the incidence of peritonsillar abscess, highlighting the broader impact of public health interventions on infectious diseases. Further research is needed to explore the effects on other respiratory infections and diseases.

This report describes a rare occurrence of benign fibrous histiocytoma in the frontal sinus of a 38-year-old male. The patient presented with acute symptoms, including sudden-onset headache, nausea, and general discomfort, although neurological, otorhinolaryngological and laboratory examinations showed no abnormalities. A cranial CT scan revealed a cystic, osteodestructive lesion measuring 2.5 cm in the far lateral right frontal sinus, initially suspected to be a mucocele due to radiological characteristics and the patient’s history of recurring frontal headaches and retrobulbar pressure. Elective surgical excision was performed via an external supraorbital approach due to the lesion’s lateral location. Histopathological examination of the excised tissue revealed characteristic features of benign fibrous histiocytoma, including spindle cell proliferation and the presence of histiocytes and siderophages. Immunohistochemistry further supported the diagnosis, showing EMA, S100, and creatinine negativity with SMA positivity. This case is unique, as it represents the first reported benign fibrous histiocytoma in the frontal sinus. During regular follow-up, the patient remained symptom-free and showed no recurrence. This report underscores the importance of considering rare diagnoses for cystic skull lesions and supports tailored surgical approaches based on lesion location.